Summary: Mrs X and Miss X complain about the events surrounding Miss X’s removal from home and detention in hospital under the Mental Health Act 1983. We have decided not to investigate their complaints about the Council.

The complaint

1. Mrs X and her daughter, Miss X, complain the Council and NHS organisations acted with fault in relation to:
• planning for and carrying out the removal of Miss X from the family home following an assessment of Miss X under the Mental Health Act 1983;
• raising and acting on safeguarding concerns about Mrs X and another family member potentially neglecting or abusing Miss X;
• not giving Mrs X information about Miss X while Miss X was detained in hospital under the Mental Health Act 1983;
• not allowing, or failing to help, contact between Miss X and her family while Miss X was in hospital;
• trying to arrange a further detention in hospital or a deprivation of liberty when Miss X remained in hospital after the detention lapsed;
• delaying Miss X’s return home from hospital; and
• complaint handling.
2. The complainants say the faults caused them the following injustice.
• A lengthy and distressing removal of Miss X from the family home, involving the Police, fire services, and sedation against her will. This was traumatic for Miss X and her family.
• The Police arrested and interviewed Mrs X and another family member. They are concerned that this will affect their employment.
• Mrs X had no information about or contact with Miss X for several weeks while Miss X was in hospital a long way from home.
• The distressing impact of what the complainants consider race discrimination and breaches of their human rights.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start an investigation if we decide the tests set out in our Assessment Code are not met. (Local Government Act 1974, section 24A(6), as amended)
4. The Local Government and Social Care Ombudsman (LGSCO) investigates complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as NHS organisations (Local Government Act 1974, sections 25 and 34(1), as amended). Sometimes, we may work jointly with the Parliamentary and Health Service Ombudsman (PHSO) to jointly investigate complaints about health and social care that meet our criteria.
5. We cannot investigate a complaint if it is about action taken by or on behalf of any local policing body in connection with the investigation or prevention of crime. (Local Government Act 1974, Schedule 5, Section 26, paragraph 2 as amended)
6. We cannot investigate a complaint about the start of court action or what happened in court. (Local Government Act 1974, Schedule 5/5A, paragraph 1/3, as amended)
7. We normally expect someone to refer the matter to the Information Commissioner if they have a complaint about access to their data. However, we may decide to investigate if we think there are good reasons. (Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

8. I considered information provided by the complainants and PHSO. This includes the organisations’ records from the events Mrs X and Miss X complain about.
9. I considered the Ombudsman’s Assessment Code.
10. The complainants have had an opportunity to comment on a draft version of this decision. I considered their comments before making a final decision.

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My assessment

11. The complaint involves the actions of the Council and NHS staff. It also involves the actions of a private hospital acting for the NHS. I have summarised Mrs X and Miss X’s complaints about the Council below.
• A) The Council failed to plan and prepare adequately for removing Miss X from the family home, and its key approved mental health professional (AMHP) was not present throughout the event. Council and medical records contained flawed information about events leading up to the removal. This could have wrongly influenced the Council’s decisions and actions leading to removing Miss X from her home.
• B) The Council considered safeguarding concerns the NHS raised with it, shared them with the Police and made assumptions it would not have made had the family been from a different ethnic background.
• C) The Council failed to give Mrs X information about Miss X while Miss X was in hospital. It also wrongly told Mrs X that she could not have contact with Miss X while she was detained in hospital. It wrongly stated that Mrs X had been bailed and the Police had advised she should not have contact with Miss X.
• D) When Miss X’s hospital detention was due to lapse, the Council tried to arrange a further detention there, and then a deprivation of liberty. This breached Miss X’s human rights.
• E) The Council’s handing of Mrs X and Miss X’s complaints, and their requests for information, was poor.
12. We can separate these issues from Mrs X and Miss X’s other complaints about the actions of the NHS and the private hospital. We will therefore not start a joint investigation with PHSO.

A – the Council’s actions leading up to and including Miss X’s removal from home

13. The Council applied for a court warrant allowing the Police to enter Miss X’s home and remove her from it.
14. We cannot investigate the Council’s application to the court, the warrant itself, the Council’s actions as permitted by the warrant, or the actions of the Police.
15. We cannot investigate Miss X’s removal from her home, because this was an action of the Police. They, with the help of other emergency services, removed Miss X from her home.
16. I have considered whether we should investigate the Council’s actions:
• leading up to its application for a warrant, and/or
• on the day Miss X was removed from her home (unless permitted by the court warrant).
17. Having done so, I have decided that we should not investigate these issues, for the following reasons.
• The records already provided to us are extensive and show the serious concerns many NHS and Council professionals had about Miss X’s health and living conditions. Miss X had refused help in her own home. Miss X’s sister and Mrs X both agreed with the professionals that Miss X needed to be detained in hospital. There is no indication in the records that the key decisions, to detain Miss X and remove her from home against her will, were influenced by discrimination. It is therefore unlikely an investigation would find fault in the way the Council decided to apply for Miss X’s detention in hospital and for a court warrant enabling the Police to remove her from her home if she refused to go willingly.
• The records also show the Council was mindful of the distress and trauma Miss X could suffer through being removed from home against her will and planned to minimise this. The events on the day Miss X was taken from home to hospital were protracted and traumatic. However, the records already available suggest this was because of Miss X’s condition and presentation at the time, rather than fault by the Council.

B – the Council’s actions in response to safeguarding concerns

18. The records we have seen show that:
• Miss X had isolated herself in the attic of Mrs X’s house for 18 years, had not spoken to Mrs X for about five years, and was living in unsanitary conditions;
• Mrs X eventually raised concerns with health services, but Miss X would not speak to professionals or allow them into her room;
• NHS staff raised safeguarding concerns with the Council after seeing Miss X at home and taking note of her living conditions;
• their concerns included Miss X’s family not raising concerns sooner with professionals about Miss X’s extreme self-neglect and isolation;
• in response, the Council started a formal safeguarding enquiry;
• when the Police attended Miss X and Mrs X’s home to remove Miss X from it, they decided to arrest Mrs X and another family member having seen the situation for themselves;
• the Council closed its safeguarding enquiry after Miss X was taken to hospital but re-opened it following a referral from the Police and a request to re-consider the situation while Miss X was in hospital; and
• the Council closed the enquiry again after discussing the issues with mental health services and considering that Miss X was safe while in hospital, was not returning home at that time, and further discussions would happen before she left hospital.
19. Regardless of what information the Council gave the Police, it was the Police’s decision to make arrests on the day. Therefore, we cannot investigate this part of the complaint.
20. The Council has a duty under section 42 of the Care Act 2014 to make enquiries if it has “reasonable cause to suspect” a person may be at risk of abuse or neglect and has care and support needs which mean the person cannot protect themselves. The Council must also decide whether it or another person or agency should take any action to protect the person from abuse.
21. Based on the available records, it is unlikely that an Ombudsman investigation would find fault with the Council:
• starting a safeguarding enquiry based on the referral it received;
• ending the investigation after Miss X was taken to hospital; or
• re-opening the investigation to reconsider the issues following further referrals, and then closing it again.

C and D – the Council’s actions while Miss X was in hospital

22. Miss X was initially detained in hospital under section 2 of the Mental Health Act 1983. When this detention lapsed, Miss X remained in hospital as an ‘informal patient’. She moved to a different hospital, still as an ‘informal patient’, and eventually moved back home. Miss X’s family found out where Miss X was through their own efforts and could visit her in the second hospital.
23. The available records show the Council took part in some discussions with hospital staff about whether Miss X could have contact with her family while in hospital. However, the records also say that:
• the Police and an NHS organisation were also involved in discussing family contact with hospital staff;
• the information about Mrs X being on bail and Police contact limits originated with the Police; and
• providing information to relatives and making decisions about contact was the responsibility of the hospitals.
24. Therefore, an investigation is unlikely to find that fault by the Council prevented Miss X's family having the information and contact they wanted at the time.
25. The records we have seen also show the Council was involved in considering applying for:
• a further detention in hospital under the Mental Health Act 1983; and
• an authorisation for Miss X to be deprived of her liberty in hospital, under the Mental Capacity Act 2005.
26. However, in the end these did not apply to Miss X. While finding out about this would have been distressing for Miss X, this is not a significant enough injustice for us to pursue an investigation.

E – handling of complaints and information requests

27. The complainants say the way the Council dealt with their complaints has been poor. They also say the Council resisted providing them with a copy of the warrant used to remove Miss X from her home and with Miss X’s personal records.
28. We will not investigate this part of the complaint, for the following reasons.
• The complainants now have a copy of the warrant. The courts were involved in Mrs X’s request for the warrant. We cannot investigate the court’s process, which may have had an impact on the release of the warrant and how long this took.
• My understanding is that Miss X has now received copies of her personal data from the organisations she complains about. If Miss X considers the Council is wrongly withholding personal data she is entitled to, it would be reasonable for her to take the matter to the Information Commissioner.
• We do not intend to investigate the key complaint issues and the Council’s complaint handling is difficult to separate from those. It would therefore not be a good use of our resources to investigate the complaint handling alone.

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Final decision

29. LGSCO will not investigate the parts of the complaint that relate to the Council’s actions. This is because those complaints do not meet the tests in LGSCO’s assessment code and are separable from the complaints about the NHS.

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Investigator's decision on behalf of the Ombudsman